Blue Cross Blue Shield Fep Blue Focus Reviews
FEP Blueish Focus
Enrollment
How can I enroll in FEP Blue Focus?
If you are new to the Blueish Cross and Blue Shield Service Benefit Plan or need to brand changes to your current plan, follow these steps to become started.
1. Confirm who you will encompass with your plan (Self Only, Self Plus One or Self & Family) and the product of your choice. Make annotation of the corresponding Federal Employees Health Benefits (FEHB) Programme enrollment code:
| | Cocky | Cocky + 1 | Cocky & Family |
| FEP Bluish Focus | 131 | 133 | 132 |
|---|
2. Retired federal employees (annuitants) can acquire almost enrolling here. Active employees tin enroll online using your agency's preferred method:
Employee Express:
See a list of agencies participating in Employee Express
Section of Defense:
DoD automated enrollment systems
U.S. Post:
PostalEASE system or the telephone enrollment system
Department of Free energy:
DOE automated systems
Wellness and Human Services, Department of Veterans Diplomacy and Ecology Protection:
MyPay
Employees of agencies paid through the National Finance Eye:
Employee Personal Page
3. Otherwise, you must fill up out and submit the SF 2809 Form to your Human Resources part. Delight practice not submit the form anywhere else.
Who is eligible to enroll in FEP Blue Focus?
All federal employees, annuitants and their dependents who qualify for coverage through the Federal Employees Health Benefits (FEHB) Program.
When do benefits and premiums starting time?
For active employees, your effective date is the offset day of the kickoff full pay menstruum in January. For annuitants, this date volition e'er exist Jan one.
Is this a national PPO product?
FEP Blue Focus is a national PPO product just with no out-of-network benefits. The Preferred network is the aforementioned every bit Standard and Bones Option. Members must use Preferred providers to receive benefits. Utilize our National Medico and Hospital Finder to search the directory.
Is there a pre-existing condition limitation?
No, nosotros will cover conditions you lot had prior to enrollment.
Is FEP Blue Focus considered Minimum Essential Coverage (MEC)?
Yes, it qualifies for MEC and satisfies the Patient Protection and Affordable Care Deed's (ACA) private shared responsibility requirement. FEP Blueish Focus meets the minimum value standard of threescore% established by the ACA.
Does FEP Bluish Focus authorize for the five-year rule for retirement?
Yes.
When will I receive my member ID card?
You will receive a New Fellow member Welcome Kit with your Bluish Cross and Blue Shield Service Do good Plan fellow member ID card approximately 10 business concern days from the engagement we receive your enrollment information. Y'all can also access a digital version of your member ID carte du jour via the fepblue app or online once you register for a MyBlue business relationship.
If you enroll in a Cocky But plan, you lot will receive one physical member ID card. For Self Plus One and Self and Family unit enrollments, you lot volition receive two concrete ID cards (all ID cards are in the contract holder'due south proper name). If you lot need cards for additional covered family members, y'all can request them via your MyBlue® business relationship or by calling the client service number on the back of your fellow member ID card.
Can FEP Bluish Focus members likewise use the Flexible Spending Business relationship (FSA)?
Yep, visit www.FSAFEDS.com for more than information.
Medical Benefits
Do I need to utilize a special network of providers with FEP Bluish Focus?
No. FEP Blue Focus is a national program that uses the same network of Preferred providers as Standard and Bones Choice. Use our National Doctor and Hospital Finder to search the directory.
Does FEP Blue Focus provide overseas coverage?
Yes.
What's the difference between Core, Non-core and Wrap benefits?
Core benefits are the base of the program. These benefits take a depression or no copayment and are not bailiwick to a deductible or coinsurance. These benefits are most usually used to receive general care and to maintain your overall health and well-being, in addition to coverage for adventitious injuries.
Non-cadre benefits provide coverage for any unexpected medical costs y'all may incur during the calendar year. All of these services are discipline to an annual deductible and coinsurance. When you have met the catastrophic out-of-pocket maximum, so we pay 100% of the Plan allowance for services for the residue of the calendar yr.
Wrap benefits provide the final layer of protection and complete or "wrap-up" the FEP Blue Focus do good package. These are benefits you lot may or may not have a demand to use during the year. These benefits take visit limitations and/or unlike copayments or coinsurance than the Core and Not-core benefit levels. The calendar yr deductible does not apply to these benefits.
What is my primary intendance provider (PCP) copay and specialist copay?
You pay $ten per visit for the first ten visits when you lot see a chief intendance provider, specialist or other healthcare provider, such as a mental wellness doctor. Visits to these professional providers are combined to meet the 10-visit limit per calendar year. Each member on your contract receives x visits per agenda year.
On the eleventh visit per agenda yr, your cost share volition modify to include the deductible and 30% of our allowance (known every bit coinsurance). Preventive care visits, such as an annual physical, practise not count toward the 10-visit limit and are at no price to you lot.
Is at that place an annual deductible and coinsurance with FEP Blue Focus?
Yes, the annual deductible is $500 for Cocky Simply and $1,000 for Cocky Plus One and Self and Family. The coinsurance is 30% of the Plan allowance. This deductible and coinsurance merely applies to Non-core services.
What is the out-of-pocket maximum for this plan?
The out-of-pocket maximum, also known every bit catastrophic maximum, is $vi,500 for Self Only and $13,000 for Self Plus One and Self and Family. In one case met, nosotros volition pay the entire toll of your covered benefits until the finish of the year.
Must I apply a Blue Stardom Center® for a transplant?
Some transplants are limited to services received in a Bluish Distinction Center. You'll also need to receive prior authorization. Y'all can find the transplants that require use of a Blue Distinction Centre in section 3 of the FEP Blue Focus brochure.
Is at that place a transplant travel benefit?
Yes, the transplant travel benefit is upwardly to $five,000 per transplant if you live at least 50 miles abroad from the Blue Distinction Center.
Does FEP Blue Focus run across the requirements for Mental Health Parity?
Yes.
Is there a telehealth services benefit?
Yes, you must use our contracted telehealth services vendor, Teladoc®. You'll receive two gratis telehealth visits per twelvemonth. Then, in that location is a $10 copay per visit. There is no limit on the number of telehealth visits you can utilize per calendar year. Become to the Telehealth Services page to learn more.
What infertility services are covered?
Just the diagnosis of fertility is a covered benefit.
Is there coverage for acupuncture and manipulations?
Yes, there is a $25 copay per visit and a combined visit limitation of ten visits per calendar twelvemonth.
What is the benefit for physical therapy, occupational therapy and speech therapy?
There is a $25 copay per visit and a combined visit limitation of 25 per agenda twelvemonth. Inpatient care is field of study to the deductible and 30% coinsurance.
Dental and Vision Coverage
In the FEP Blue Focus programme, are there dental benefits for routine intendance?
No, in that location is no coverage for routine dental exams or other dental services. Federal employees and retirees can purchase supplemental dental insurance through the Federal Employees Dental and Vision Insurance Programme. Learn more at opm.gov/fedvip.
Are there dental benefits for accidental, oral injury?
Yes, intendance must exist received from Preferred providers within 72 hours of the oral injury to receive accidental injury dental benefits. If you receive treatment after the 72-hour time frame, coverage volition be subject to the deductible and coinsurance.
Are at that place routine vision benefits with FEP Blue Focus?
No, there is no coverage for routine eye exams and eyewear. Federal employees and retirees can buy supplemental vision insurance through the Federal Employees Dental and Vision Insurance Program. Learn more than at opm.gov/fedvip.
Is there coverage for medical eye conditions like glaucoma?
Medical eye diagnoses, such equally glaucoma, are covered under the medical benefits of FEP Blue Focus. Yous must use Preferred providers.
Applied Behavior Analysis (ABA)
Is ABA a covered service in the FEP Blueish Focus plan?
Yes, it is a medical benefit (treatment therapy) available but for members with a diagnosis of autism spectrum disorder. Prior approval is required for ABA and all related services, including assessments, evaluations and treatment.
Are at that place limits to the ABA benefits for autism spectrum disorder when billed by a Preferred outpatient facility?
ABA for the treatment of an autism spectrum disorder is express to 200 hours per person, per calendar year.
Are ABA services offered by a school or educational setting for autism spectrum disorder covered under FEP Blue Focus?
No, services provided by a school or educational system or as a replacement are not covered nether this medical program.
Medicare
Does FEP Blue Focus coordinate with Medicare?
Yes. We coordinate FEP Blue Focus benefits with your Medicare coverage. If Medicare is your primary coverage (significant Medicare pays showtime), y'all receive the benefits outlined beneath.
If yous have Medicare Office A master:
- Nosotros will waive our calendar twelvemonth deductible and coinsurance.
- In one case you have exhausted your Medicare Part A benefits, you must then pay the coinsurance one time you satisfy the calendar year deductible for an inpatient admission.
- Precertification is required.
If yous also accept Medicare Part B primary coverage:
- We will waive our calendar year deductible, coinsurance and copayments for inpatient and outpatient services and supplies provided by physicians and other covered healthcare professional and outpatient facility services.
- We do not waive do good limitations, such as the 10-visit limit for home skilled nursing visits.
- We do not waive your coinsurance or copayments for prescription drugs.
Is there a Medicare Reimbursement Account (MRA) with FEP Blue Focus?
No, there is no MRA with FEP Blue Focus. The $600 MRA is merely for Bones Selection.
Is the prescription drug coverage with FEP Blue Focus considered "creditable coverage" under Medicare Function D?
Yes, the FEP Blue Focus prescription benefit is considered "creditable coverage" under Medicare Part D.
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Source: https://www.fepblue.org/sites/fepblue/fepblue/home/faqs-fep-blue-focus
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